Journal of the American College of Cardiology
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J. Am. Coll. Cardiol. · Mar 2019
Randomized Controlled TrialB-Type Natriuretic Peptide During Treatment With Sacubitril/Valsartan: The PARADIGM-HF Trial.
Natriuretic peptides are substrates of neprilysin; hence, B-type natriuretic peptide (BNP) concentrations rise with neprilysin inhibition. Thus, the clinical validity of measuring BNP in sacubitril/valsartan-treated patients has been questioned, and use of N-terminal pro-B-type natriuretic peptides (NT-proBNP) has been preferred and recommended. ⋯ Circulating levels of BNP may increase meaningfully early after initiation of sacubitril/valsartan. In comparison, NT-proBNP is not a substrate of neprilysin inhibition, and thus may lead to less clinical confusion when measured within 8 to 10 weeks of drug initiation. However, during treatment, either biomarker predicts the risk of major adverse outcomes in patients treated with angiotensin receptor-neprilysin inhibitors. (Prospective Comparison of ARNI with ACEI to Determine Impact on Global Mortality and Morbidity in Heart Failure [PARADIGM-HF]; NCT01035255).
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J. Am. Coll. Cardiol. · Mar 2019
Detection and Prediction of Bioprosthetic Aortic Valve Degeneration.
Bioprosthetic aortic valve degeneration is increasingly common, often unheralded, and can have catastrophic consequences. ⋯ 18F-fluoride PET-CT identifies subclinical bioprosthetic valve degeneration, providing powerful prediction of subsequent valvular dysfunction and highlighting patients at risk of valve failure. This technique holds major promise in the diagnosis of valvular degeneration and the surveillance of patients with bioprosthetic valves. (18F-Fluoride Assessment of Aortic Bioprosthesis Durability and Outcome [18F-FAABULOUS]; NCT02304276).
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J. Am. Coll. Cardiol. · Mar 2019
Editorial CommentPrecision Medicine for Heart Failure: Back to the Future.
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J. Am. Coll. Cardiol. · Mar 2019
ReviewUnderstanding Social Media: Opportunities for Cardiovascular Medicine.
Cardiology professionals have used social media platforms such as Twitter to gain exposure to new research, network with experts, share opinions, and engage in scientific debates. The power of social media to communicate openly, with wide-reaching access worldwide, and at a rate faster than ever before makes it a formidable force and voice. However, evolving individual and institutional use has resulted in uncertainty for all parties on how to optimally advance this newer digital frontier. Thus, the purpose of this paper is to: 1) introduce the basics of social media usage (with the focus on Twitter); 2) provide perspective on best social media practices in academic and clinical cardiovascular medicine; and 3) present a vision for social media and the future of cardiovascular medicine.
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J. Am. Coll. Cardiol. · Mar 2019
Multicenter StudyRelationships of Overt and Silent Brain Lesions With Cognitive Function in Patients With Atrial Fibrillation.
Patients with atrial fibrillation (AF) have an increased risk of cognitive decline, potentially resulting from clinically unrecognized vascular brain lesions. ⋯ Patients with AF have a high burden of LNCCIs and other brain lesions on systematic brain MRI screening, and most of these lesions are clinically silent. LNCCIs were associated with worse cognitive function, even among patients with clinically silent infarcts. Our findings raise the question of MRI screening in patients with AF.